Clinical Psychology Research Articles

The development of a bullying victimisation scale: the experience of Pakistani adolescents

ABSTRACT This paper describes and evaluates the procedure for the development and validation of the bullying victimisation scale for Pakistani young people aged 12–18 years. During phase I, a total of 60 participants aged from 13 to 17 years were selected by using a multistage sampling strategy for item generation for bullying victimisation. In phase II, empirical validation was carried out by 10 experienced clinical psychologists for the cultural relevance of the scale. In phase III, a pilot study was carried out on 20 participants for testing the layout of the bullying victimisation scale (BVS). In the final phase, a total of 780 participants were selected through a multi-stage sampling within the age range of 12–18 years (M = 14.78, SD = 1.33) and were given a demographic Proforma, BVS, and School Children Problem Scale. Factor analysis identified a three-factor solution for bullying victimisation, consisting of emotional bullying, verbal bullying, and physical bullying. The current findings have implications for psychological and educational professionals for the identification and management of social and emotional problems in children resulting from bullying victimisation.

Co-Designing Digital Health Intervention for Monitoring Medication and Consultation Among Transgender People in Underserved Communities: Collaborative Approach.

In many parts of the world, men who have sex with men and transgender individuals face criminalization and discrimination. As a result, they are less likely to seek medical help, despite experiencing higher rates of HIV/AIDS, mental health issues, and other health problems. Reaching key populations (KPs) with essential testing, care, and treatment services can be challenging, as they often have a higher likelihood of contracting and spreading the virus. They have limited access to antiretroviral (ARV) therapy (ART) services, which means that KPs may continue to serve as reservoirs for new HIV infections if they do not receive effective HIV programming. This ongoing issue complicates efforts to control the epidemic. Therefore, modeling a digital health system to track ARV medication access and use is crucial. This paper advocates for the use of digital interventions to manage the health of KPs in underserved regions, using Nigeria as a case study. This study aims to assess digital health interventions for monitoring medication and consultations among transgender people in underserved communities. It also sought to determine whether a system exists that could support ART adherence in Nigeria. Additionally, the study evaluated design strategies to address privacy and confidentiality concerns, aiming to reduce nonadherence to ARV medications among KPs in Nigeria. A qualitative approach was adopted for this research, involving a thematic analysis of information collected from interviews with clinicians and other health practitioners who work directly with these communities, as well as from an interactive (virtual) workshop. The findings from the thematic analysis indicate a need to increase attendance at ART therapy sessions through the implementation of an intensive care web app. Unlike previous solutions, this study highlights the importance of incorporating a reminder feature that integrates with an in-app telemedicine consultancy platform. This platform would facilitate discussions about client challenges, such as adverse drug effects, counseling sessions with clinical psychologists, and the impact of identity discrimination on mental health. Other data-driven health needs identified in the study are unique drug request nodes, client-led viral load calculators, remote requests, and drug delivery features within the web app. Participants also emphasized the importance of monitoring medication compliance and incorporating user feedback mechanisms, such as ratings and encouragement symbols (eg, stars, checkmarks), to motivate adherence. The study concludes that technology-driven solutions could enhance ART adherence and reduce HIV transmission among transgender people. It also recommends that local governments and international organizations collaborate and invest in health management services that prioritize health needs over identity.

A - 87 Exploring the Utility of the Montreal Cognitive Assessment to Identify Neurocognitive Deficits among Adult Patients with Sickle Cell Disease

Abstract Objective Neurocognitive deficits associated with sickle cell disease (SCD) have been well established in the pediatric population but studies examining the adult neurocognitive profile are lacking. This study examined the utility of the Montreal Cognitive Assessment (MoCA) to screen patients for cognitive impairments within a multidisciplinary adult sickle cell clinic. Method Patients who presented to their scheduled appointment at the UCSF Benioff Children’s Hospital Oakland Adult Sickle Cell Clinic were provided psychoeducation and offered neurocognitive screening. Those that accepted completed a brief clinical interview and were screened with the MoCA by neuropsychology externs or a licensed clinical psychologist. Results A sample of 24 patients (M age = 37.63, age range = 18–75; female =58.33%) were screened with the MoCA. Of patients screened, 41.67% (n = 10) were identified as mildly impaired (M score = 22) and 16.67% (n = 4) were identified as moderately impaired (M score = 15.5), consistent with other studies in the literature. Overall MoCA score and the memory subdomain were both negatively correlated with increasing age (r = −0.15, p < 0.05 and r = −0.06, p < 0.05 respectively). Conclusions Utilizing the MoCA, our study demonstrates a notable prevalence of cognitive impairment identified in 58.43% of adult SCD patients, with a marked decline associated with advancing age. These findings suggest the MoCA’s utility; however, further research is needed to understand the validity of this measure in detecting the varying levels of cognitive impairment in adult SCD patients. Such measures could significantly enhance the care and quality of life for individuals with SCD and address age disparities in SCD, where resources for adult patients are much more limited.

Assessment of mood after severe acquired brain injury: Interviews with UK clinical psychologists and medical professionals

Objective Mood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population. Design Following their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes). Participants Twenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews. Results Both groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself. Conclusions No ‘gold standard’ approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful.

Exploring considerations of equality, diversity and inclusion in selection for a doctorate in clinical psychology programme: A qualitative study

Diverse and inclusive healthcare workforces are important to optimise patient access and outcomes. Various attempts have been made to promote equality, diversity and inclusion (EDI) in clinical psychology; however, clinical psychology doctoral training programmes (DClinPsy) frequently fail to reflect the population demographics of the communities that they serve within the make-up of their trainees. Some research indicates that the lack of diversity might be linked to potential biases within the selection process.This study seeks to qualitatively explore how application screeners and interview panellists for a DClinPsy programme consider EDI in the selection process. Content analysis of seven semi-structured interviews suggests that participants think broadly about EDI, considering differences between marginalised groups and the provision of equal access for members of these groups. Content analysis of discussions of protected characteristics suggests that, when considering EDI, race, sex, disability, sexual orientation, and socio-economic status prove more salient than other factors such as age, and religion or belief.Barriers and facilitators to accessing the DClinPsy are discussed. Participants discuss the perceived inadequacy of EDI training for their roles in selection, and conflicts related to different EDI measures such as positive action and standardisation. The findings are discussed with reference to existing literature. Future research should seek to examine the EDI training needs of those involved in the selection process and examine the efficacy of EDI initiatives to improve equity and inclusion for underrepresented groups.

Organizational factors associated with less use of restraints in older adults with dementia in acute care hospitals: A scoping review.

Dementia affects more than 55 million people worldwide. Use of restraints for hospitalized older adults with dementia is a social issue that should be addressed systematically and should not depend on the characteristics of nurses. This study reviewed the literature on organizational factors associated with reducing use of restraints in older adults with dementia admitted to acute care hospitals. A scoping review was performed. Three databases were searched for papers that met our eligibility criteria. Factors related to restraint reduction were extracted, and results were deduced. Through inductive analysis, subthemes were categorized according to similarities and differences, which were then integrated into broader themes. Sixteen studies were eligible for inclusion. The prevalence of restraints ranged from 5.1% to 80.0% depending on how the meaning of restraint was interpreted. The most common indications for restraints were history of falls and fall risk. Interdisciplinary screening for restraints was associated with reduced prevalence of restraints, with a 0.18-fold (confidence interval [CI]: 0.12-0.24) reduction through use of a restraint decision flowchart and a 0.76-fold (CI: 0.63-0.92) reduction through consultation with a psychiatrist. Interdisciplinary members included nurses, physicians, clinical psychologists, pharmacists, respiratory therapists, and therapists. Research is needed to introduce and develop an interdisciplinary restraint decision-making system and to test its effectiveness. Important factors in implementing alternatives to restraints are the harmful effects of restraints, expertise in dementia, regular education on alternative methods, an inpatient environment that ensures patient safety, and the development of human resources.

Altmetric coverage of health research in Ireland 2017-2023: a protocol for a cross-sectional analysis.

Scientific publications have been growing exponentially, contributing to an oversaturated information environment. Quantifying a research output's impact and reach cannot be solely measured by traditional metrics like citation counts as these have a lag time and are largely focused on an academic audience. There is increasing recognition to consider 'alternative metrics' or altmetrics to measure more immediate and broader impacts of research. Better understanding of altmetrics can help researchers better navigate evolving information environments and changing appetites for different types of research. Our study aims to: 1) analyse the amount and medium of Altmetric coverage of health research produced by Irish organisations (2017 - 2023), identifying changes over time and 2) investigate differences in the amount of coverage between clinical areas (e.g., nutrition vs. neurology). Using Altmetric institutional access, we will gather data on research outputs published 1 January 2017 through 31 December 2023 from active Irish organisations with Research Organisation Registry (ROR) IDs. Outputs will be deduplicated and stratified by their Australian and New Zealand Standard Research Classification relating to ≥1 field of health research: Biological Sciences, Biomedical and Clinical Sciences, Chemical Sciences, Health Sciences, and Psychology. We will clean data using R and perform descriptive analyses, establishing counts and frequencies of coverage by clinical area and medium (e.g., traditional news, X, etc.); data will be plotted on a yearly and quarterly basis where appropriate. Improved understanding of one's information environment can help researchers better navigate their local landscapes and identify pathways for more effective communication to the public. All R code will be made available open-source, allowing researchers to adapt it to evaluate their local landscapes.

Acceptance and Commitment Therapy for the Treatment of Postpartum Depression: A Case Study Approach

The prevalence of postpartum depression (PPD) has been linked to contradictory outcomes for mothers, infants, and mother-child relationships. Pakistan has the greatest prevalence percentage among the Asian countries which ranges from 28%-63% (Habiba et al., 2020). When it comes to treating postpartum depression, one of the best methods is Acceptance and Commitment Therapy. (Hayes et al., 2006). However, a large number of new mothers choose not to seek expert assistance, which highlights the need for new platforms to be developed in order to provide health care services in Pakistan. As noted by Waters et al. (2020) the primary goal of this research is to develop and evaluate the ACT for postpartum depression in postpartum women. This treatment approach addresses mood and anxiety problems related to perinatal diseases. Utilizing the single-case study design. Our main resource who woman who volunteered, from teenage mothers to women in their forties who give birth. The intervention protocols and the strategy were developed in close collaboration with seasoned clinical psychologists and psychiatrists who are experts in the sector. The program was conducted weekly for a minimum of 12 weeks, during which the technique and treatment plan were explained in full. Compiling the patient's progress report and compiling the data received during treatment were done using computation. At the conclusion of the session, there was a notable decline in the severity of anxiety and depression symptoms. The goal is to compile positive evidence supporting the feasibility, efficacy, and proof-of-concept of ACT in reducing depressive symptoms in the postpartum phase. The advantages and disadvantages of this format were examined, along with their prospective applications in clinical health care and future research.

Promoting Geropsychology: A Memorandum for Research, Policies, Education Programs, and Practices for Healthy Aging.

This viewpoint paper reports the state of the art at a global level on research, practice and assessment, policies, and training in the clinical psychology of aging and, more specifically, in geropsychology. The main sources of information were as follows: (1) the most recent reviews of the literature available in the scientific literature; (2) the resources on the internet referable to professional and academic associations dealing with the topic; and (3) the laws, policy initiatives, and funded programs that are aimed at the diffusion and applications of mental health in aging. The present study aims to provide an updated and comprehensive memorandum highlighting the importance of prioritizing mental health in older adults. It seeks to promote health in general and disease prevention strategies, ensuring equitable access to mental health services integrated into primary care and designed for aging. This paper also aims to shed light on the slow development process and lack of consolidation in the adaptation of academic training at master's and doctoral levels in most developed countries, despite the long-declared importance of enhancing resources for the promotion of geropsychology. The results of the present study are patchy. Although the importance of enhancing resources for the promotion of geropsychology has long been declared, the development process seems very slow, and the adaptation of academic training at master's and doctoral levels in most developed countries-those that, for demographic reasons and attitudes, should be more sensitive to the issue, does not yet seem to have consolidated. Collaboration among diverse professionals is crucial for providing integrated and comprehensive care to older adults that addresses their physical, psychological, and social needs.

Mencegah kekambuhan pada pecandu narkoba: Bagaimana peranan craving dan dukungan keluarga?

Previous research data shows that drug users who have undergone rehabilitation can still experience relapse, so research that identifies factors that cause relapse is essential. This study aims to examine the relationship between craving and family support with the tendency to relapse. The research participants were 97 drug addicts undergoing rehabilitation at several rehabilitation institutions in Surabaya and Gresik. The research scale was compiled by the researcher himself, consisting of a relapse scale (α = 0.935), which refers to the theory of Gorski and Miller, a craving scale (α = 0.899), which refers to Drummond's theory, and a family support scale (α = 0.949) which refers to Friedman's theory. The research data were analyzed using multiple regression tests. The results of the partial test showed that the higher the craving in people with an addiction who had undergone rehabilitation, the higher their tendency to relapse. However, the results of the partial test also proved that solid family support made the tendency to relapse lower. The results of the study simultaneously also showed that craving and family support were predictors of the tendency to relapse in drug addicts after rehabilitation. These findings are expected to broaden understanding of clinical psychology and provide practical guidelines for former addicts to prevent relapse through efforts to reduce cravings and increase family support.

Quality improvement project (QIP): evaluating a pilot suicide awareness, screening and signposting training intervention for dental care professionals in a dental teaching hospital and school

Scotland’s 2022 suicide prevention strategy recommends building skills and knowledge among healthcare staff who play a role in preventing suicide. A quality improvement project (QIP) in relation to this was...

Клинические особенности и коморбидные нейропсихиатрические состояния у педиатрических пациентов с тикозными расстройствами. Обзор.

INTRODUCTION. Tic disorders are a common neurological pathology among children and adolescents. Tic disorders and comorbid conditions affect patients' socialization, education, and emotional state. Social stigmatization and discrimination caused by tic disorders have an irreparable impact on personality development, making it necessary to raise awareness and understanding of these conditions. AIM. The objective of this study is to analyze the literature on the features of the etiology, diagnosis, and clinical manifestations of tic disorders and comorbid disorders. MATERIAL AND METHODS. An analysis of DSM-5-TR and ICD-11 criteria, as well as 28 international literature sources from the PubMed database, was performed. This analysis provided descriptions of the diagnostic criteria, etiology, and pathogenesis of tic disorders and comorbid disorders. Data on the clinical manifestations of comorbid disorders, differential diagnosis, and main treatment approaches were also presented. RESULTS AND DISCUSSION. The prevalence of tic disorders is about 1% of the population, with 1 in 5 schoolchildren experiencing tics during their development. Currently, the exact causes of tics are unknown; it is assumed that tic disorders is a multifactorial disease involving heredity, environmental factors, and immune-mediated mechanisms. Additionally, dysfunctions in the cortico-striato-thalamo-cortical circuits and neurotransmitter imbalances play significant roles. About 80% of patients with tics have comorbid neuropsychiatric disorders such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, autism spectrum disorders, mixed anxiety-depressive disorders, and sleep disturbances, which in some cases present challenges in the differential diagnosis and treatment of these conditions. CONCLUSION. The high degree of comorbidity in tic disorders necessitates a multidisciplinary approach, involving neurologists, psychiatrists, clinical psychologists, and behavioral therapy specialists. This collaboration aims to achieve the maximum therapeutic effect and improve the quality of life for patients. KEYWORDS: tics, chronic tics, Tourette syndrome, Gilles de la Tourette Disorder

Clinical Education: Addressing Prior Trauma and Its Impacts in Medical Settings.

Prior trauma exposure significantly increases the risk of developing PTSD following medical stressors and may contribute to the development of medically induced PTSD. However, healthcare systems often overlook the interaction between prior trauma and current medical stressors, contributing to negative psychosocial and health-related outcomes for patients. Integration of both trauma-informed and trauma-focused practices into psychosocial programming in medical settings may be key to effectively addressing the needs of trauma-exposed patients. Yet, there is a lack of practical guidance on how clinical psychologists in medical settings can respond to trauma's effects in routine clinical practice. This paper aims to provide an overview of trauma-focused theory, assessment, and treatment considerations within medical settings, emphasizing the importance of incorporating trauma-focused intervention into integrated psychosocial programming to address prior trauma and its impacts on care in order to improve patient outcomes.

158 Evaluation of a multi-modal rehabilitation programme for people affected by cancer: the Active Together service

Abstract Purpose Rehabilitation (including prehabilitation) can help cancer patients prepare for and recover well from treatment, improve physical and psychological outcomes, and reduce demand on healthcare resources. Project description Active Together is a novel evidence-based multi-modal rehabilitation service for patients with cancer before, during and after their treatment. It was developed collaboratively by Sheffield Hallam University’s Advanced Wellbeing Research Centre (AWRC) and Sheffield Teaching Hospitals NHS Trust and funded by Yorkshire Cancer Research charity. The service is personalised to individual needs and includes exercise, nutrition, and psychological support. The service is delivered by a clinical team combining physiotherapists, exercise specialists, dietitians, and clinical psychologists at the AWRC and two community health and exercise facilities, with plans to extend to more sites as the service expands. Since launching in 2022, over 600 patients with either lung, colorectal, or upper gastrointestinal cancer have received support from the Active Together service. The evaluation of the service examines physical and psychological outcomes, alongside healthcare resource use. Service uptake and attrition rates will be examined by demographics such as age, gender, and ethnicity. The evaluation is due be completed in August 2024; therefore, the results will be available for this presentation. Conclusions The evaluation of this service will assess the feasibility and effectiveness of the Active Together Service in improving the lives of cancer patients, and addressing the health inequalities and barriers which may prevent someone from accessing the Active Together service. If the evaluation produces positive outcomes, it will support the case for embedding multimodal rehabilitation services within routine cancer care. Funding The Active Together service is funded by Yorkshire Cancer Research.

Josephine D. Johnson (1951-2023).

This article memorializes Josephine D. Johnson (1951-2023), clinical psychologist. Johnson contributed significantly to the evolution of multicultural psychology. She served as Chair of the American Psychological Association (APA) Task Force on the Implementation of the Multicultural Guidelines. Highlights of Johnson's career and her professional contributions are noted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why (not) rely on patients’ perspectives? Time for a meaningful standard to measure and define patient-specific change in clinical psychology.

Why (not) rely on patients’ perspectives? Time for a meaningful standard to measure and define patient-specific change in clinical psychology.

Challenging the primacy of behavioral phenomena in eating disorders: Commentary on Sala and colleagues (2014), the study of eating disorders from a network perspective: A scoping systematic review, clinical psychology: Science and practice.

Challenging the primacy of behavioral phenomena in eating disorders: Commentary on Sala and colleagues (2014), the study of eating disorders from a network perspective: A scoping systematic review, clinical psychology: Science and practice.

La fonction des écrits dans les relations entre la théorie et la pratique en psychiatrie et psychologie clinique. À la mémoire de Georges Lanteri-Laura et de Jean Garrabé

Among the many ways in which knowledge is transmitted in psychiatry and clinical psychology, written communication has always been a vast field. But new means of expression and communication have brought about a diversity in the modalities used in teaching and personal training in the midst of the diversification of psychiatric currents, the means of exploration, and therapeutic methods. The relationship between theory and practice is central to the means of transmission in the specific characteristics of the different currents of French psychiatry: 1) Psychiatric conceptions which focus on the various neurobiological and biochemical networks, genetic research and artificial intelligence are confronted in their current evolution with the epistemological demands of explanation and understanding. And psychiatry, in all its complexity, cannot and will not be spared adopting these same demands; 2) The different psychopathological dimensions that underlie the various concepts of psychiatric disorders in children, adolescents and adults are constantly confronted with the relationship between theoretical conceptions and practical modalities, in the clinical relationship and in therapeutic conduct. In this article, we propose to address a certain number of reflections in this field, by questioning the principal psychopathological conceptions of today. And this reflection places great emphasis on the need to clarify concepts, perspectives and projects; 3) Epistemological dimensions can thereby render it possible to identify the numerous articles concerning the transmission of psychiatry and its fields: – First and foremost, studies on the relationship between theory and practice make it possible to distinguish between the various categories. They provide a clear understanding of the specific dynamics involved in understanding psychiatric disorders; – Studies on the relationship between the fields of time and life sciences correspond to very important epistemological attitudes that are very important to be taken into account. The neurosciences which are currently playing a key role in medicine and psychiatry usher us into “the knowledge of life”. These various studies compel us to consider just what the relationship is betweenthe “objectivity of the scientist” and the “subjectivity of the living”. We can then turn our attention to the anthropological concepts concerning the philosophy of life where we will find in the various psychiatric disorders the essential questions about the meaning of life that are present in the mind of every human being.

Exploring The Efficacy Of Acceptance And Commitment Therapy (ACT) Group Sessions In Reducing Maternal Stress Among Mothers With Autism

This study investigates the impact of Acceptance and Commitment Therapy (ACT) group sessions on maternal stress among six mothers of children diagnosed with autism, in India. The sessions were facilitated by a team consisting of a clinical psychologist and a Board Certified Behavior Analyst who implemented evidence based techniques combining Relational Frame Theory and culturally modified ACT. Maternal stress is a critical concern, particularly in the context of individuals with autism, where ASD specific challenges may amplify the daily pressures both social and parenting that is experienced by mothers. The study utilized a pre-post intervention design, assessing maternal stress levels before and after participants attended ACT based group sessions. The results revealed a significant reduction in maternal stress scores following participation in the ACT group sessions, measured using tools such as the Autism Parenting Stress Index (APSI) and The Family Adjustment to Childhood Developmental Disability (FICD). The findings suggest that the structured and supportive environment provided by ACT counselling sessions contributed to a meaningful decrease in stress levels among the mothers who participated in the study. The cultural context of India adds depth to the understanding of how therapeutic interventions can be adapted to diverse populations, emphasizing the need for use of evidence based methods such as ACT in parent training and counselling. Additionally, the use of this method furthers the parent’s acceptance of Autism as a lifelong condition and transforms their parenting approach. This research not only contributes to the growing body of literature on interventions for individuals with autism and their families but also underscores the adaptability of evidence-based practices in diverse cultural settings. Further exploration and replication of these findings with larger sample sizes are recommended to strengthen the evidence supporting the use of ACT group sessions as a valuable tool in mitigating maternal stress among mothers with autism in the Indian context.

Group Metacognitive Therapy for Pediatric Obsessive-Compulsive Disorder: A Pilot Study

Cognitive-behavioral therapy including exposure and response prevention is the first-line treatment of pediatric OCD showing response- and remission rates around 70% and 53%. Thus, there is room for improvements. Metacognitive therapy (MCT) for OCD might be cost-effective and focuses on modifying metacognitive beliefs about the significance and dangerousness of intrusive thoughts/feelings, and about the need to perform rituals. MCT is effective in adults but needs to be evaluated in youths. In the current study, eleven adolescents divided in three groups received eight MCT group sessions of 75 minutes duration (and two 60 minutes workshop for parents) delivered by an MCT-therapist and an assistant. The within-group effect size (hedges g) from pre- to post-treatment on the CY-BOCS was 1.90, and the response and remission rates were 82% and 55%, respectively. Effect sizes for secondary outcomes were also large. Therapist time (one certified MCT-therapist and a clinical psychology student working together) used per patient to achieve these results were 2.18 therapy sessions of 75-minutes duration in addition to 33 minutes therapist time per patient of workshops for the parents. Follow-up assessments were not available, and the results should be interpreted with caution. However, they are encouraging and suggest that MCT for pediatric OCD should be evaluated further.